This month the Know-It-All Sisters Mary Lloyd and Barbara Morris address a concern from reader “Hale, Hearty and Poorer” who wants to know how to opt out of the “medical machine”. As always, the Know-It-All Sisters, who always know absolutely everything about everything, tackle the issue, perhaps not to the satisfaction of Hale, Herty and Poorer, but the Sisters do their best. If you would like to add to the discussion, please leave a comment
Here we go:
Dear KIA Sisters,
Recently, I had a health scare that turned out not to be serious. But now I’m scared about something else. Once I was “in the system” I didn’t have much say in what I was or wasn’t going to have done. Lots of tests and even a proposed ambulance ride “just to be safe.” The whole thing was a ridiculous waste of money and resources. What could I have done to avoid that? How can I be responsible about taking care of my health and without getting stuck in this steamroller of “medical machine” we have in place?
Hale, Hearty, and Poorer
Sister Mary Says:
I’m with you, sister. What we have going now as “medicine” does seem like a menacing, uncontrollable, money-guzzling machine in certain circumstances. Taking care of your health without being taken over by the system is a tricky proposition. Yeah for you for wanting to do it. You will be healthier and your grandkids (and mine) will have a better life for the effort.
So what can you –and I—do to be good healthcare consumers?
I like the words you used to phrase the dilemma: “How can I be responsible about taking care of my health…?” Seeing it as your personal responsibility instead of expecting someone to make you feel better whenever you don’t is a great start. We all need to take responsibility for eating wisely, being active enough to keep our bodies functioning well, and foregoing things that aren’t good for us physically—like tobacco and stress.
That’s a personal quest that will be unique for each of us, but it’s still ours to do. Too often, we agree to take a pill instead of improving our lifestyle choices. That’s simpler for “the machine” than keeping track of how you’re doing on an ongoing basis and it’s simpler for you.
But think about the side effects. Very rarely do prescription drugs come with positive side effects. When you agree to take that pill instead of going the “harder’ route, you may well end up with another problem—or more than one–because of what the drug is doing to your body. With lifestyle choices, the opposite is true. When you decide to start walking to reduce your stress, you’ll soon discover that it’s also helping you—with your weight, your endurance, and maybe even your outlook.
So as a first step, every time you have the option, choose to make the lifestyle choice rather than asking your body to deal with a drug–or a surgical procedure.
The second piece of this is being selective in how you interact with your healthcare providers. An intelligent approach to healthcare is no longer simply a case of knowing when to call the doctor. Many healthcare organizations give you more than one option for getting help. Calling the 24/7 Nurse Hotline may give you enough information to deal with the problem. Going to the urgent care clinic instead of the emergency room will get you in and out faster. (Get your medical drama on TV.)
Forego the temptation of asking the doctor to “fix it” every time you feel uncomfortable. Seeing your family physician for a head cold after three days wastes your time and someone’s (yours or Medicare’s) money. Many things go away on their own if given the chance. Be smart about deciding both when you need to get your healthcare provider involved and how you access them. Learn the difference between “pain” and “discomfort.”
Every time you end up in that doctor’s office you take on two addition risks. First, because sick people go there, you might end up catching something a lot worse than what you went to get help with. Second, once you are “in the system,” your control over what will and won’t be done diminishes considerably.
To stay as far away from “the machine” as you can and still be responsible, you need to make wise decisions about both IF and HOW to get your health care providers involved.
The third leg of this stool is having as much in place as you can so that when you do need significant amounts of medical care, your healthcare providers and loved ones are aware of what you do and don’t want. If you are coherent, ask questions. Find out what the procedure they want to do will accomplish and why it’s important to do it. (I’ve instructed my sons not to let anyone do tests and procedures on me simply to “try something.” That kind of guessing game rarely does more than run up a huge bill and make the patient miserable.)
It also helps to do all you can to identify what’s happening yourself. Make a strong effort to explain the pain or problem concisely rather than just saying “My side hurts.” We could probably save ten hours of every medical professional’s work week if we were better at this. They are trying to help. If you don’t help them, they will resort to more tests and procedures to figure out things you could have told them.
Be clear—with your family and the medical staff—about what’s wrong, what you need, and what you don’t want.
These three strategies might not keep “the machine” totally out of your life, but they will help you minimize your encounters with it. Good luck!
Sister Barbara Says:
I feel your pain and I’m not kidding. You echo angst felt by many, many people, especially older people.
About excessive tests and other rigmarole: One important reason many doctors go out of their way to order tests and take precautions that may seem unnecessary is fear of a ruinous malpractice suit over a wrong diagnosis or treatment. 
I’m encouraged that you understand that your health is YOUR responsibility. There are many ways to take personal responsibility, and one of the best ways to avoid being stuck in the steamroller of the “medical machine” is to be responsible for what you do or do not put into your body over time. Eventually, your body is a reflection of what you do to, it nutritionally, physically, mentally, and even medically.
Unfortunately, many people look to their traditionally trained physician for nutrition guidance, but that’s not always wise. As far back as 1985 the National Academy of Sciences reported that “Nutrition education programs in US medical schools are largely inadequate to meet present and future demands of the medical profession.” 
Prevailing wisdom is that “For the most part, the regular everyday person with our Western diet doesn’t really need any vitamin supplementation,” said John Blumer, physician with Glynn Family Medicine Center of the Southeast Georgia Health System. “We get all we need in our regular diet.” 
Considering that many of us live on a nutritionally bankrupt diet of processed junk and fast food, are we foolish enough to believe “We get all we need in our regular diet”? Tragically, that’s what too many well meaning but inadequately trained doctors tell patients who ask about supplements.
It’s obvious that you can’t eat worthless “food” on a regular basis, and fail to take supplements to replace what’s missing in the diet, and not expect to get sick or have a less than vital quality of life.
In 2003, the Lewin Group published “New Study Finds Increased Multivitamin Use By The Elderly Could Save Medicare $1.6 Billion” (4) It stated, “The results of a new study released today show that the daily use of a multivitamin by older adults could lead to more than $1.6 billion in Medicare savings over the next five years.”
Here we are eight years later and too many doctors still tell patients, “You don’t need to take supplements because you get what you need in your regular diet.”
We are on the brink of dismantling the best health care system in the world so more people will have access to medications that at best, do little more than manage symptoms, and at worst, cause another health issue or even result in a fatality. We need more common sense and an admission that supplementing an almost universally impoverished diet is necessary to stay healthy.
My best advice is to connect with a traditionally trained physician who understands the value of optimum nutrition, or better yet, a naturopathic physician. A well-trained naturopath knows about nutrition and what it takes to stay well. Some suggestions offered may be foreign to you but keep an open mind and do your own research about the condition you are seeking help for. Doing your own research is an important part of taking responsibility.